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Hospitalisation

Hospitalisation

During 2011-12, there were 1,024,462 hospital separations in WA, of which 75,306 (7.4%) were identified as Indigenous [1]. 10 The age-standardised separation rate of 1,563 separations per 1,000 for Indigenous people was 3.8 times higher than the rate for other people in WA. Around 39% of the separations identified as Indigenous involved overnight hospital stays, and 60% were same-day acute separations (the details of a small number of the overall separations were not reported). The age-standardised separation rate for Indigenous people for overnight stays was 2.4 times the rate for non-Indigenous people. Excluding same-day separations for renal dialysis, for which rates were much higher for Indigenous people than for non-Indigenous people, the age-adjusted separation rate for same-day separations was 1.3 times higher for non-Indigenous people than for Indigenous people

Age-specific separation rates

In WA in 2008-10, separation rates were higher for Indigenous people than those for non-Indigenous people for all age-groups, except the 65 years and older age-group; the highest disparities occurred in the middle adult years (Table 5) [2].

Numbers include separations for which Indigenous status was not stated

Rates are expressed as separations per 1,000 population

Rate ratio is the Indigenous rate divided by the non-Indigenous rate

Rate ratios for ‘All ages’ are directly age-standardised using the 2001 Australian standard population (*)

0-4

438

246

1.8

367

181

2.0

403

214

1.9

5–14

137

93

1.5

108

75

1.4

123

85

1.5

15–24

188

132

1.4

432

228

1.9

306

178

1.7

25–34

272

142

1.9

595

355

1.7

430

245

1.8

35–44

464

188

2.5

575

324

1.8

520

255

2.0

45–54

580

273

2.1

579

331

1.7

580

302

1.9

55–64

676

457

1.5

709

447

1.6

693

452

1.5

65+

855

920

0.9

800

764

1.0

824

837

1.0

All ages

329

290

1.5*

436

349

1.6*

382

319

1.5*

Causes of hospitalisation

In 2008-10, the most common cause of hospitalisation among Indigenous people living in WA was for the International Classification of Diseases (ICD) group ‘Care involving dialysis’ (Table 6) [2]. (Many of these separations involved repeat admissions for the same people, some on an almost daily basis.) After age-adjustment, the rate of 764 per 1,000 for Indigenous people was almost 16 times higher than the rate for non-Indigenous people. After excluding dialysis, ICD ‘Injury, poisoning and certain other consequences of external causes’ (including motor vehicle accidents, assaults, self-inflicted harm and falls) was the next most common cause of hospitalisation for Indigenous people, with an Indigenous rate of 65 per 1,000 which was 2.9 times higher than the non-Indigenous rate. The next leading cause of hospitalisation for Indigenous people was for respiratory conditions with an Indigenous rate of 56 per 1,000 which was 4.0 times higher than the non-Indigenous rate.

Numbers include separations for which Indigenous status was not stated

Rates are expressed as separations per 1,000 population and directly age-standardised using the 2001 Australian standard population

Rate ratio is the Indigenous rate divided by the non-Indigenous rate

Injury, poisoning and certain other consequences of external causes

65

23

2.9

Disease of the respiratory system

56

14

4.0

Disease of the digestive system

38

39

1.0

Symptoms, signs and abnormal clinical and laboratory findings

37

23

1.6

Disease of the circulatory system

36

19

1.9

Pregnancy, childbirth and the puerperium

35

21

1.6

Mental and behavioural disorders

33

13

2.6

Endocrine, nutritional and metabolic diseases

29

8.6

3.4

Disease of the genitourinary system

23

16

1.4

Disease of the skin and subcutaneous tissue

19

5.7

3.3

Certain infectious and parasitic diseases

14

4.8

2.9

Other

96

129

0.7

Care involving dialysis

764

49

15.5

Total

1,245

364

3.4

Endnotes

‘Separation’ refers to an episode of admitted patient care, which can be either a patient’s total stay in hospital or part of a patient’s stay in hospital that results in a change to the type of care (e.g. from acute to rehabilitation). Hospital separations are more widely known as ‘admissions’, but can also be referred to as ‘hospitalisations’.

The overall level of identification of Indigenous people in WA’s public hospitals was very good at 96%, but the level was only 90% for admissions in inner regional and remote areas.

References

Australian Institute of Health and Welfare (2013) Australian hospital statistics 2011–12. Canberra: Australian Institute of Health and Welfare